signs of a bad unit

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I'm a senior nursing student who also works in a hospital and I'm looking for some advice. I will be graduating in the less than a year , I have started to look at options for future employment. I have been floating to different units and I have seen drastic differences between the different units. I'm not looking for the perfect unit , but I'm looking for one that tolerable and one that I'm comfortable at working in. Any advice on signs of a bad unit and things that should not be tolerated?

Look for a core group of senior staff. There will be bunches and bunches of newbies, to be sure, but most shifts will have 2 or 3 or more senior staff. A few senior staff -- one in charge and two or more spread out through the unit -- can serve as mentors and resources for all the newbies. It helps if the newbies are willing to be mentored.

Ask about orientation and who your preceptors are. You want at least two main preceptors, three at the most. Our pattern is one senior preceptor and one relatively new nurse (about two years) who is just learning to precept. The new preceptor solidifies her knowledge of nursing and the patient population while teaching and at the same time the senior preceptor guides both the new preceptor and the orientee. It's an effective use of senior staff. And you'll get a fairly good orientation, as long as the new preceptor isn't full of herself and is willing to be mentored.

I still see a high turn over rate as a bad sign, for this particular unit a good portion of people left because of the unit. Some of them went to other floors so it had nothing to do with CRNA school. I'm not a job hopper and would like to spend time at a job. Plus having a high turn over rate will eventually takes a toll on the hospital. Spending money to train employees only to have them leave in a short while cannot be good for business .

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I agree, where I work there are two CNAs for 60 patients and that is on a good day, so of course there are plenty of codes and falls, and everything else because the nurses have so much to do, they can't monitor there patients enough to provide preventative care.

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We had a few nurses with 20+ years of experience but they left or went into our virtual ICU.

What is a virtual ICU? I'm not familiar with it.

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Specializes in Critical Care.

Look for a unit with a good nurse retention rate. If everyone else is happy and wants to stay, chances are you'll want to also.

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I agree, where I work there are two CNAs for 60 patients and that is on a good day, so of course there are plenty of codes and falls, and everything else because the nurses have so much to do, they can't monitor there patients enough to provide preventative care.

Well thats sounds terrible, Is it long term care?

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OOps forgot the quote!

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I work on a bad unit.

1. Excessive use of travel and agency nurses

2. New grads outnumber experienced nurses

3. New grads placed in charge (!!!!)

4. Extremely high turnover.

5. Nurses being forced to work as sitters/aides AND carry a patient assignment as a nurse

6. Being called nearly every day to pick up shifts

7. Needing to give nurses sign on bonuses or bonuses for picking up extra shifts

That is just off the top of my head. I am sure there are more.

Sounds just like the place I just left.

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On 10/23/2015 at 2:36 PM, NOADLS said:

CNA's not taking orders from nurses. Red flag.

Another one is if nurses are doing CNA work (ie changing diapers, toileting patients)

You might think the second one is the product of the resources you are given, but I firmly believe that if a workplace isn't giving you CNA's, then it isn't worth the time or effort to stay there.

You some ignorant. If you think it's just a cnas job to clean an assistant patients with ADL's. You must have gotten your license out of a cereal box.

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Specializes in NICU/Mother-Baby/Peds/Mgmt.
On 10/24/2015 at 6:23 AM, sjalv said:

I think I work on a 'good' unit, so perhaps this can provide some perspective. For the record, I work in a CVICU.

  • We always have a unit secretary, on both day and night shift.
  • We always have at least one tech, usually two.
  • Nurses are never tripled.
  • Very sick patients such as fresh open hearts, therapeutic hypothermia patients, and IABP patients are 1:1.
  • The charge nurse never has to take a patient so they are available to help if needed, and are very good about doing so. The charge nurses round frequently to make sure we (staff nurses) do not need any help.
  • We (nursing staff) always ask each other if help is needed when our own patients are taken care of.
  • We almost always have time to take a lunch break, since even if you have very critical patients, nurses who do not are willing to watch yours while you run to the cafeteria.
  • Around shift change, if we notice another nurse is very behind, we'll do things like get their patients up into the chair, empty their foley bags, mark and chart their chest tube outputs, make sure their patients don't need anything, give any unpassed meds etc so they can catch up.
  • When the morning staff gets there, the clinical lead usually rounds to make sure none of the night shift nurses need any help finishing their shift.
  • When we get an admit, the charge and at least two other nurses or a nurse and a tech are in there with you to help get your patient settled: put them on the cardiac monitor, get a blood pressure, get height/weight/temp, get them into a gown, give them a quick bed bath, and other necessary things we do to all admits like screen for flu vaccination etc. This is so you can quickly assimilate them into your care so your other patient doesn't get neglected while you try to get them settled in.

I think a lot of what I mentioned centralizes around simply having good teamwork, which is necessary in any area of nursing but especially in critical care. Either your unit has it or they don't.

I worked in a unit like this, St Louis Children's NICU. It was one of the best places I ever worked and while they called often for people to work extra (or texted or asked you to stay late or come in early) staffing was almost always fine and if it wasn't people helped you.

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Specializes in Medsurg.
1 hour ago, Mary lou said:

You some ignorant. If you think it's just a cnas job to clean an assistant patients with ADL's. You must have gotten your license out of a cereal box.

Lol I was gonna say something similar but you worded it ever so nicely. I look down on nurses that think that's only a CNAs job. Not apologetic, oh well.

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